NPIMap

Organization Active NPI

Ms Methodist Hospital & Rehabilitation Center

  • Durable Medical Equipment & Medical Supplies
  • Hattiesburg, MS
National Provider Identifier
1831237874
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
43-278 Issued in MS
Legal business name
MS METHODIST HOSPITAL & REHABILITATION CENTER
Practice address
107 Fairfield Dr
Hattiesburg, MS 39402-1681
Phone
(601) 264-0359
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gary Armstrong
Title
Exec Vice President
Phone
(601) 981-2611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 43-278 MS Primary

Addresses

Primary practice location

107 Fairfield Dr
Hattiesburg, MS 39402-1681

Mailing address

1350 E Woodrow Wilson Ave
Jackson, MS 39216-5112
Phone (601) 981-2611

Other identifiers 1

IdentifierTypeStateIssuer
00040292MedicaidMS

Other names 1

  • Methodist Rehab Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930074613 MS DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply Company With Prosthetic Personnel 8921912270 Practice locations: Hattiesburg, MS

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Msmethodist Hospital & Rehabilitati107 Fairfield Dr, Hattiesburg, MS 39402-1682(601) 264-0359 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Jan 1, 2026

National Provider Directory

National Provider Directory
Tax ID family
Ms Methodist Reham DME14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

107 Fairfield Dr
Hattiesburg, MS 39402
Phone (601) 264-0359

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Methodist Rehab CenterJackson, MS, CCN 25T152 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1831237874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E WOODROW WILSON AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165112",
            "telephone_number": "601-981-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 FAIRFIELD DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021681",
            "telephone_number": "601-264-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS METHODIST HOSPITAL & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "EXEC VICE PRESIDENT",
        "authorized_official_telephone_number": "601-981-2611"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "43-278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040292",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.